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MEMORIAL MARITIME CLINIC INC. NPI 1528122389


NPI Information

NPI: 1528122389
Provider Name: MEMORIAL MARITIME CLINIC, INC.
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
150 S PICO AVE
LONG BEACH, CA
ZIP 90802
Phone: (562) 432-2820
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MEMORIAL MARITIME CLINIC, INC. is a family medicine in Long Beach, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MEMORIAL MARITIME CLINIC, INC. NPI is 1528122389. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

150 S PICO AVE
LONG BEACH, CA
ZIP 90802
Phone: (562) 432-2820
Fax: (562) 437-1353

The provider's authorized official is Mark Perez .
The authorized official title is Owner and has the following contact phone number (562) 432-2821.

The enumeration date for this NPI number is 12/19/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineG067514CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G675140OTHERCALIFORNIABLUE SHIELD OF CA
2G00675140MEDICAIDCALIFORNIA
3G67514OTHERCALIFORNIAMED LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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